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NPI Code Detail

MEDICARE: JENNIFER A HENDRIX

MEDICARE: JENNIFER A HENDRIX
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator
2101Y00000XCounselor

General Provider Information

NPI Number : 1558993691
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER A HENDRIX
Provider Business Mailing Address
First Line : 27871 N 3950 RD
Second Line :
City : OCHELATA
State : OK
Zip : 74051-2005
Country : US
Telephone Number : 918-534-6313
Fax Number :
Provider Business Practice Location Address
First Line : 401 S DEWEY AVE STE 108
Second Line :
City : BARTLESVILLE
State : OK
Zip : 74003-3525
Country : US
Telephone Number : 918-336-0810
Fax Number : 918-336-0836
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2020
Last Update Date : 03/22/2024

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